Alterations of sympathetic nervous system, coagulation and platelet function in gestational diabetes

被引:9
作者
Poyhonen-Alho, Maritta [1 ]
Joutsi-Korhonen, Lotta [2 ,3 ]
Lassila, Riitta [2 ,3 ]
Kaaja, Risto [4 ,5 ]
机构
[1] Univ Cent Hosp, Dept Obstet & Gynecol, Helsinki, Finland
[2] HUSLAB Lab Serv, Coagulat Unit, Dept Hematol, Helsinki, Finland
[3] HUSLAB Lab Serv, Coagulat Unit, Dept Clin Chem, Helsinki, Finland
[4] Turku Univ, Dept Med, Pori, Finland
[5] Satakunta Cent Hosp, Pori, Finland
关键词
coagulation; gestational diabetes; platelet function; pregnancy; sympathetic nervous system; GLUCOSE-TOLERANCE TEST; INSULIN-RESISTANCE; FIBRINOLYTIC DYSFUNCTION; WOMEN; INHIBITION; HYPERGLYCEMIA; ACTIVATION; MELLITUS; HYPERCOAGULABILITY; EPINEPHRINE;
D O I
10.1097/MBC.0b013e3283540c2d
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Gestational diabetes is associated with increased risk for venous thromboembolism. Activation of sympathetic nervous system affects blood coagulation, fibrinolysis and platelet activation by several mechanisms. We aimed to study the relationship of sympathetic nervous system, coagulation and platelet function in gestational diabetes. Forty-one white women with gestational diabetes, 22 healthy pregnant and 14 nonpregnant controls were studied. We assayed serial nocturnal (at 12 p.m., 4 a.m. and 7 a.m.) changes of the adrenergic transmitter noradrenaline, coagulation variables and platelet activation with PFA-100. Plasma noradrenaline increased from 4 to 7 a.m. in both pregnant groups. During the same time period, prothrombin time (PT) shortened in gestational diabetes compared with healthy pregnant and nonpregnant controls. In gestational diabetes, nocturnal FVIII:C levels were lower compared with normal pregnancy and also variables associated with von Willebrand factor tended to be lower. Platelet activity increased at midnight in pregnant women compared with nonpregnant women without differences between gestational diabetes and normal pregnancy. Gestational diabetes is associated with concomitant early morning sympathetic stimulation and activation of extrinsic coagulation pathway (shortened PT). Decreased FVIII:C may refer to compensatory anticoagulatory mechanism. These alterations could reflect increased risk of pregnancy-related thromboembolism in gestational diabetes. Blood Coagul Fibrinolysis 23:508-513 (C) 2012 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.
引用
收藏
页码:508 / 513
页数:6
相关论文
共 30 条
  • [1] EVALUATION OF 3-HOUR ORAL GLUCOSE-TOLERANCE TEST IN DETECTION OF SIGNIFICANT HYPERGLYCEMIA AND HYPOGLYCEMIA IN PREGNANCY
    ABELL, DA
    BEISCHER, NA
    [J]. DIABETES, 1975, 24 (10) : 874 - 880
  • [2] Gestational diabetes has no additional effect on plasma thrombin-activatable fibrinolysis inhibitor antigen levels beyond pregnancy
    Akinci, Baris
    Demir, Tevfik
    Saygili, Saba
    Yener, Serkan
    Alacacioglu, Inci
    Saygili, Fatih
    Bayraktar, Firat
    Yesil, Sena
    [J]. DIABETES RESEARCH AND CLINICAL PRACTICE, 2008, 81 (01) : 93 - 96
  • [3] Serum osteoprotegerin is associated with carotid intima media thickness in women with previous gestational diabetes
    Akinci, Baris
    Demir, Teufik
    Celtik, Aygul
    Baris, Mustafa
    Yener, Serkan
    Ozcan, Mehmet Ali
    Yuksel, Faize
    Secil, Mustafa
    Yesil, Sena
    [J]. DIABETES RESEARCH AND CLINICAL PRACTICE, 2008, 82 (02) : 172 - 178
  • [4] Role of catecholamines in platelet function: Pathophysiological and clinical significance
    Anfossi, G
    Trovati, M
    [J]. EUROPEAN JOURNAL OF CLINICAL INVESTIGATION, 1996, 26 (05) : 353 - 370
  • [5] Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis
    Bellamy, Leanne
    Casas, Juan-Pablo
    Hingorani, Aroon D.
    Williams, David
    [J]. LANCET, 2009, 373 (9677) : 1773 - 1779
  • [6] Coagulation and fibrinolysis parameters in normal pregnancy and in gestational diabetes
    Bellart, J
    Gilabert, R
    Fontcuberta, F
    Carreras, E
    Miralles, RM
    Cabero, L
    [J]. AMERICAN JOURNAL OF PERINATOLOGY, 1998, 15 (08) : 479 - 486
  • [7] INHIBITION OF AGGREGATION OF BLOOD PLATELETS BY NUCLEOSIDES
    CLAYTON, S
    CROSS, MJ
    BORN, GVR
    [J]. NATURE, 1963, 200 (490) : 138 - &
  • [8] Fibrinolytic dysfunction in insulin-resistant women with previous gestational diabetes
    Farhan, S
    Winzer, C
    Tura, A
    Quehenberger, P
    Bieglmaier, C
    Wagner, OF
    Huber, K
    Waldhäusl, W
    Pacini, G
    Kautzky-Willer, A
    [J]. EUROPEAN JOURNAL OF CLINICAL INVESTIGATION, 2006, 36 (05) : 345 - 352
  • [9] Platelet inhibition by insulin is absent in type 2 diabetes mellitus
    Ferreira, IA
    Mocking, AIM
    Feijge, MAH
    Gorter, G
    van Haeften, TW
    Heemskerk, JWM
    Akkerman, JWN
    [J]. ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY, 2006, 26 (02) : 417 - 422
  • [10] IRS-1 mediates inhibition of Ca2+ mobilization by insulin via the inhibitory G-protein Gi
    Ferreira, IA
    Eybrechts, KL
    Mocking, AIM
    Kroner, C
    Akkerman, JWN
    [J]. JOURNAL OF BIOLOGICAL CHEMISTRY, 2004, 279 (05) : 3254 - 3264